Perspectives On Depression

Maybe It Is, Maybe It Isn’t

When I sat down at the keyboard to type tonight, I went totally blank. I had no ideas whatsoever. So I did what I usually do when this happens: I typed the word “depression” into the Google News search and sifted through the results.

Two stories sort of piqued my interest, even though they were fairly different in nature. The first came from 99.9 WBUR in Boston. According to a study by Boston economist Paul Greenberg, major depression is costing the American economy $210.5 billion a year. That number was $83.1 billion in the year 2000. The study speculated that the tremendous increase in cases of depression (particularly in those 50 or older) could have been sparked by the recent economic recession in the U.S.

The second was an opinion piece written for the New York Times by Hilary Jacobs Hendel, titled “It’s Not Always Depression.” In the piece, Hendel describes her work with a patient named Brian. Brian had basically been through every type of depression treatment imaginable, with the exception of electroshock therapy, which he did not want to do. Hendel eventually zeroed in on Brian’s chronic shame, developed from a childhood of emotional neglect. Once she was able to do that, she began the process of helping Brian experience emotions again and reducing the shame. After meeting twice a week for four years, Brian finally reached a point of recovery.

There has been lots of talk lately about how depression is a disease. A popular analogy these days is to compare depression with other diseases, such as asthma or cancer. In fact, there was a cartoon circulating around the internet not long ago titled “If Physical Diseases Were Treated Like Mental Illness” which puts this comparison in visual form. To an extent, it is an apt comparison; major depression is not something one just “gets over” usually, even though a great many people think recovery is simply a matter of will power.

What worries me, though, is that to call depression a “disease” is a fairly one-dimension description of it. It makes it sound like you can just pop an aspirin in the morning and alleviate all the symptoms the rest of the day. Indeed, I think many people have this mindset already. “If I can just find the right antidepressant, I will get better.” Well, in Brian’s case, he had taken just about every antidepressant known to man, and he was still nearly comatose. He had been treated for the disease, but he was far from being cured.

Depression is a sum of parts. It may be fueled by shame or anxiety or physical illness or guilt or any number of other factors. Everyone has a lifetime of experiences they bring into the arena with depression. Granted, in some instances, the cause of depression can be more chemical in nature, and medication can improve a person’s mood drastically. In most cases, though, without some type of therapy, a person will likely not ever reach a place of full recovery (if that is even possible with depression). Experiences that have shaped a person’s way of thinking must be reckoned with.

Greenberg’s study does actually point out how the word “depression” actually encompasses a great many mental and mood disorders. The headlines, though, always trumpet the word “depression” and nothing else. There is so much more to it than just that. If we don’t understand this, the dollar amounts in Greenberg’s next report may reach the stars.